As countries confront new health care challenges in the 21st century, their health care systems reflect the problems and political settlements of an earlier age. Meeting these new challenges requires reform of existing health care system arrangements while reconciling the goals of equitable access to quality care at an affordable price. This book compares health care reforms in industrialized nations and the Global South to uncover the similarities and differences in their problems and solutions. It examines the struggle over the Affordable Care Act and its alternatives in the United States, major health care reforms in Germany in the new century, and South Africa's efforts to combat AIDS and construct a comprehensive health care system for all. These particular reforms reflect the underlying configuration of politics in each country.

Susan Giaimo is a Visiting Assistant Professor in the Departments of Political Science and Biomedical Sciences at Marquette University, USA. She was a postdoctoral fellow in the Robert Wood Johnson Foundation Scholars in Health Policy Research Program at the University of California at Berkeley, USA. She also taught at the Massachusetts Institute of Technology, USA.

“One of the most important sets of policy decisions that all governments make is the selection, development and maintenance of a healthcare system. Giaimo not only offers a comprehensive elucidation of several important existing systems—helpfully, in both middle-income and high-income countries—but also places them in the context of how politics shapes key decisions and how such choices then shape subsequent policies and politics. This book is essential reading for both students of and experts in health systems.” (Jeffrey Drope, Vice President, Economic and Health Policy Research, American Cancer Society, USA)

“Health care systems are pivotal for the welfare state: They deliver services to citizens, not transfers. Health care systems shape welfare state experience, and they do so in different ways. The decision to include South Africa in a comparative study with Germany and the USA throws light on all three countries. This book is a valuable contribution to comparative policy studies.” (Stephan Leibfried, Professor of Social Policy, Head of the Research Center on Transformations of the State, University of Bremen, Germany)

“What is most distinctive about Susan Giaimo's book is its comparative perspective. Rather than treating the US as sui generis, she explicitly compares it to Germany. In a similar vein, rather than confining her analysis to the affluent democracies, Giaimo compares the US and Germany to South Africa. The result is a comprehensive overview of both the problems and forces driving health care reform in different regions of the globe.” (Jonah Levy, Associate Professor of Political Science, University of California at Berkeley, USA)